How would you approach a patient with prostate cancer with PSMA+ non-regional lymph nodes?
Assume non regional nodes are non pathological by size. Patient also has pelvic nodes that are positive.
Would you consider this low metastatic burden of disease and how would you treat? Prostate alone? What dose? 55 Gy/20 or 60 Gy/20 fx or dose escalation conventional fractionation?
2 Answers
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Radiation Oncology · Case Western Reserve University/ University Hospitals Seidman Cancer Center
Answered on
If we take the question at face value, this is a patient with de novo mHSPC and the treatment recommendation would be ADT (level 1) + ARPI (level 1) + RT to primary (level 1) and consideration of RT to metastatic sites (level 3 data).
However, I would use one of the multiple PSMA-RADS-like scoring sy...
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
If non regional nodes are common iliac or lower pa nodes then favor definitive management with RT to nodal region along with the prostate.
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